Long-Term Cardiopulmonary Outcomes and Quality of Life: A Comparative Study Among Cigarette, Electronic Cigarette and Dual use Consumers.

Abstract Background: Smoking is a leading cause of heart and lung diseases worldwide. Though there is a decline in tobacco smoking the use of e-cigarettes is growing in popularity.Objective:To assess the long-term effects of smoking, vaping, and dual use on cardiopulmonary function capacity and quality of life.Methods:The study participants were classified into five groups: Control, Individuals who use cigarettes only, Individuals who only use e-cigarettes, Individuals who previously smoked and currently use only e-cigarettes and Individuals who use both cigarettes and e-cigarettes. Participants performed PFT, 6MWT and completed HRQoL questionnaire.Results:A total of 175(85.7% male) participants with an average age of mean(±SD)27.38(±5.75) enrolled in the study. PFT results showed significant difference in FEV₁(L/Sec) [F (4,170) = 7.73, p≤ 0.001] η²=0.15; FEV₁(%predicted) [F (4,170) =24.63, p≤0.001] η²=0.36; and FEV₁/FVC (%) [F (4,170) =16.85, p≤0.001] η² = 0.28 values across the five groups. On further analysis, FEV₁and FEV₁(%predicted) significantly decreased in all user groups. Similarly, in FEV₁/FVC (%) significant difference was observed with user groups except those who only use e-cigarettes. 6MWT showed a significant difference in walking distance [F (4,170) = 19.93, p≤0.001] η² =0.31. HRQoL reported a significant difference in physical function [H (4) =20.55, p≤0.001], emotional well-being [H (4) =19.21, p=0.001], and social function [H (4) =29.63, p≤0.001] domains. Individuals who use both cigarettes and e-cigarettes reported a significant decline in lung function [(FEV₁2.96±0.41, FEV₁(% predicted) 72.6±6.07 and FEV₁/FVC (%) 73.65±11], 6MWT walking distance(m) (mean ±SD) 416.26±53.49.Conclusion: Weobserved a significant long-term impairment in lung function, cardiopulmonary capacity, and quality of life among individuals who use cigarettes and e-cigarettes compared to those who never smoked or vaped. Also, individuals who use both cigarettes and e-cigarettes showed the worst health outcomes.